Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies
CPT4 code
Name of the Procedure:
Excision of 1 or More Lesions of Small or Large Intestine Not Requiring Anastomosis, Exteriorization, or Fistulization; Multiple Enterotomies
Summary
In this surgical procedure, one or more lesions (areas of abnormal tissue) in the small or large intestine are removed. The surgery does not involve connecting (anastomosis), bringing part of the intestine outside the body (exteriorization), or creating an opening for drainage (fistulization). Instead, it uses multiple small incisions (enterotomies) to access and remove the lesions.
Purpose
The procedure addresses lesions in the intestine, which can include polyps, tumors, or areas of inflammation. The goal is to remove abnormal tissue to prevent potential complications such as blockages, bleeding, or the spread of malignant cells.
Indications
- Presence of intestinal polyps or tumors
- Areas of inflammation, such as in Crohn's disease
- Intestinal lesions causing bleeding, pain, or obstruction
- Abnormal tissue detected through diagnostic imaging or endoscopy
Preparation
- Fasting for at least 6-8 hours before the procedure
- Possible adjustment or cessation of certain medications, especially blood thinners
- Undergoing preoperative diagnostic tests such as blood work and imaging studies
- A bowel prep to clear the intestines may be required
Procedure Description
- The patient is placed under general anesthesia.
- Multiple small incisions (enterotomies) are made in the abdomen.
- Specialized surgical tools are used to locate and excise the lesions from the small or large intestine.
- The incisions in the intestine are carefully sutured.
- The abdominal incisions are closed and bandaged.
Duration
The procedure typically takes between 1 to 3 hours, depending on the number and complexity of the lesions.
Setting
Performed in a hospital or a specialized surgical center equipped with the necessary facilities.
Personnel
- Surgeon specialized in gastrointestinal surgery
- Anesthesiologist
- Surgical nurses
- Support staff including scrub techs and anesthetic assistants
Risks and Complications
- Infection at the surgical site
- Bleeding
- Injury to surrounding organs or tissues
- Adhesions or scar tissue formation
- Anesthetic complications
- Rare: bowel perforation
Benefits
- Removal of abnormal tissues preventing further complications
- Relief from symptoms such as pain and bleeding
- Prevention of potential malignant transformation in precancerous lesions
- Improved intestinal function
Recovery
- Hospital stay of 1-3 days for monitoring
- Pain management with prescribed medications
- Gradual return to normal diet starting with liquids and moving to solids
- Limitations on strenuous activities for several weeks
- Follow-up appointments to monitor healing and ensure no recurrence of lesions
Alternatives
- Endoscopic removal for more accessible lesions
- Less invasive laparoscopic surgery
- Medication management for inflammatory conditions
- Regular monitoring and surveillance with imaging and endoscopy
Patient Experience
During:
- The patient will be under general anesthesia and will not feel pain during the procedure.
After:
- Some pain and discomfort managed with medications
- Activity restrictions and gradual return to normal activities
- Possible dietary changes to accommodate healing
- Regular follow-up visits for monitoring and ensuring recovery